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Re: [IPk] Into the blood (was: Post meal BGs)

I think this injecting i.v. thing is a red herring. Boluses are a complement
of the basal régime and we have to realise that as diabetics we have to
compromise on our lifestyles and plan forward: which in this case means
building up the basal rate prior to meals to cope with the initial surge of
BG, even if you use Humalog. This is a relatively safe routine which allows
sufficient time for errors in dosage to be corrected. The consequences of an
i.v. overdose of insulin would be very rapid and therefore dangerous for the
individual and for others (i.e. BG decreasing faster than you could get
glucose on board orally) and this outweighs the occasional benefit of a fast
correction of hyperglycaemia.

This ties in to the comments made by correspondents concerning exercising:
my experience with my modest half hour evening jog is that I should have
made all the adjustments to dosage well in advance of commencing the
exercise to achieve the best control  - a reduction in basal rate at least 2
hours before on Humalog. By the time I start exercising I put the rate back
to normal because it will not affect my blood sugar during or for some time
after the run. Of course longer duration activity requires a different
strategy and of course I don't always practice what I preach, as the
decision to go out is often last minute!

Incidentally, do any of you find as I do that blood seeps back up the
catheter when you reduce the basal rate below a certain value? This would be
another possible reason for needing a bolus after exercise as some have
remarked, in addition to the more obvious one of having reduced the basal
rate too late, or overcompensating on the CHO front.
-----Message d'origine-----
De : Pat Reynolds <email @ redacted>
À : email @ redacted <email @ redacted>
Date : samedi 30 octobre 1999 10:29
Objet : [IPk] Into the blood (was: Post meal BGs)


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